Kicking the habit works best in pairs. That's the main message of a study presented today at EuroPrevent 2019, a scientific congress of the European Society of Cardiology (ESC). "Quitting smoking can be a lonely endeavour," said study author Magda Lampridou, of Imperial College London, UK. "People feel left out when they skip the smoke break at work or avoid social occasions. On top of that, there are nicotine withdrawal symptoms. Partners can distract each other from the cravings by going for a walk or to the cinema and encouraging replacement activities like eating healthy food or meditating when alone. Active support works best, rather than nagging."

Half of coronary patients smoke and 90% of people at high risk of cardiovascular disease are smokers. ESC cardiovascular prevention guidelines advise against tobacco in any form, and people who stop smoking generally halve their risk of cardiovascular disease.2 "Smoking cessation interventions should incorporate couples where possible to achieve a smoke-free household," said Ms Lampridou.

This study evaluated the supporting role married or cohabiting partners might have in smoking cessation. The study enrolled 222 current smokers who were at high risk of cardiovascular disease or had suffered a heart attack. Partners were also recruited: 99 were current smokers (45%), 40 ex-smokers, and 83 never-smokers.

Couples attended one of four preventive cardiology programmes: EUROACTION, EUROACTION plus, MyAction Galway, and MyAction Westminster. At the start they were asked about current smoking status, history of smoking, and previous quit attempts. Smoking status was validated with a carbon monoxide breath test. During the 16-week programme, couples were offered nicotine replacement therapy with patches and gum. In one programme, participants could choose the prescription drug varenicline instead.

At the end of the programme, 64% of patients and 75% of partners were abstinent -- compared to none and 55% at the start, respectively. The odds of quitting smoking at 16 weeks were significantly higher (5.83-fold) in couples who tried to quit together compared to patients who attempted it alone.

"Previous research has shown that ex-smokers can also positively influence their spouse's attempts to quit, but in this study the effect was not statistically significant," said Ms Lampridou. "As for non-smoking partners, there is a strong risk that they will adopt their spouse's habit." Ms Lampridou noted that research is needed to confirm the findings in smokers who are otherwise healthy.